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Methicillin-resistant Staphylococcus aureus (MRSA) represents a serious threat to the health of hospitalized patients. Attempts to reduce the spread of MRSA have largely depended on hospital hygiene and patient isolation. These measures have met with mixed success: although some countries have almost eliminated MRSA or remained largely free of the organism, others have seen substantial increases despite rigorous control policies. We use a mathematical model to show how these increases can be explained by considering both hospital and community reservoirs of MRSA colonization. We show how the timing of the intervention, the level of resource provision, and chance combine to determine whether control measures succeed or fail. We find that even control measures able to repeatedly prevent sustained outbreaks in the short-term can result in long-term control failure resulting from gradual increases in the community reservoir. If resources do not scale with MRSA prevalence, isolation policies can fail "catastrophically."

Original publication

DOI

10.1073/pnas.0401324101

Type

Journal article

Journal

Proc Natl Acad Sci U S A

Publication Date

06/07/2004

Volume

101

Pages

10223 - 10228

Keywords

Community-Acquired Infections, Cross Infection, Humans, Mathematics, Methicillin Resistance, Patient Isolation, Staphylococcal Infections, Staphylococcus aureus, Stochastic Processes